HIV RISK BEHAVIORS AMONG URBAN NOMAD DRUG INJECTORS

城市游牧吸毒者的艾滋病毒风险行为

• 批准号: 6523136
• 负责人: DON C DES JARLAIS
• 金额: $ 60.41万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-05 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6523136
• 关键词: AIDS; AIDS /HIV diagnosis; HIV infections; behavioral /social science research tag; clinical research; communicable disease diagnosis; communicable disease transmission; computer assisted diagnosis; counseling; data collection methodology /evaluation; disease /disorder proneness /risk; hepatitis B; hepatitis C; high risk behavior /lifestyle; human migration; human subject; interview; intravenous drug abuse; longitudinal human study; questionnaires; residential mobility; substance abuse related behavior; urban area; young adult human (21-34)

The global diffusion of HIV, hepatitis B and hepatitis C among injecting drug users (IDUs) shows both that they engage in substantial travel and that research is needed on their travel patterns. Previous research makes it clear that IDUs travel regionally, nationally, and internationally, but has not adequately described travel patterns nor the factors that influence IDUs' HIV risk behavior when they travel. Through our street-based research with IDUs in New York City, we have developed considerable familiarity with a large group of highly mobile, young IDUs, self-defined as "urban nomads", who travel frequently and widely throughout the U.S. These urban nomads are often homeless, but are conceptually and behaviorally distinct from "locally homeless" drug injectors who are not geographically mobile. The specific aims include both methodological and substantive objectives: (Aim 1) Analytically describe a large sample (n = 800) of "urban nomad" young IDUs, including their demographics, drug use histories, travel histories, HIV risk behaviors and serostatus. Identify factors associated with (a) HIV risk behaviors and (b) frequency of intercity travel. (Aim 2) Identify patterns of drug use and HIV risk behavior during travel by urban nomad IDUs, including numbers of "person-trips" (a trip by a person to another metropolitan area), the geographic distribution of person- trips where HIV risk behaviors do and do not occur, and factors that differentiate person-trips with and without HIV risk behavior. Aims 1 and 2 will be achieved through interviews with 600 urban nomad IDUs recruited in New York City and 200 urban nomad IDUs recruited at collaborating research sites across the country. (Aim 3) Implement and assess a long-distance telephone follow-up interview system for collecting data from urban nomad IDUs in their travels. Subjects will be intensively prepared to maintain telephone contact with researchers. Long-distance telephone interviewing will be supplemented by referrals to local research studies for HIV counseling and testing, by referrals to syringe exchange programs, and by e-mail and web site communication. (Aim 4) Determine potential biases in loss to follow-up in using these techniques. Estimated biases can then be used to adjust estimates of continuing drug use and risk behaviors. Aims 3 and 4 will be achieved through a cohort study of 300 subjects recruited in New York. Drug use and HIV risk behavior among IDUs are often viewed as local phenomena, with drug practices, risk behaviors and HIV epidemics occurring within defined geographic areas. The proposed research will provide data and research technologies for a complementary perspective that sees drug use practices and blood-borne pathogens diffusing within a loosely integrated nation-wide "system" of illicit drug use.

艾滋病毒、B型肝炎和C型肝炎在注射吸毒者中的全球传播表明，他们经常旅行，需要对其旅行模式进行研究。以前的研究清楚地表明，注射吸毒者在区域、国家和国际上旅行，但没有充分描述旅行模式，也没有充分描述影响注射吸毒者旅行时艾滋病毒风险行为的因素。通过我们在纽约市对注射吸毒者的街头研究，我们已经相当熟悉一大群高度移动的年轻的注射吸毒者，他们自我定义为“城市游牧民”，经常在美国各地广泛旅行。这些城市游牧民通常无家可归，但在概念上和行为上与“当地无家可归”的药物注射者不同，他们在地理上不是移动的。具体目标包括方法目标和实质性目标：（目标1）分析性地描述大量“城市游牧”青年注射吸毒者样本（n = 800），包括其人口统计学、吸毒史、旅行史、艾滋病毒危险行为和血清状况。确定与（a）艾滋病毒风险行为和（B）城市间旅行频率相关的因素。(Aim 2）确定城市流动注射吸毒者旅行期间的药物使用和艾滋病毒风险行为模式，包括“个人旅行”（一个人到另一个大都市地区的旅行）的数量，发生和不发生艾滋病毒风险行为的个人旅行的地理分布，以及区分有和没有艾滋病毒风险行为的个人旅行的因素。将通过与在纽约市招募的600名城市流动注射吸毒者和在全国各地的合作研究点招募的200名城市流动注射吸毒者进行访谈来实现目标1和2。(Aim（3）实施和评估长途电话随访访谈系统，以便收集城市流动注射吸毒者旅行中的数据。受试者将做好充分准备，以便与研究者保持电话联系。除了远程电话访谈外，还将转介到当地进行艾滋病毒咨询和检测的研究，转介到注射器交换方案，以及通过电子邮件和网站交流。(Aim 4）确定使用这些技术时失访的潜在偏差。估计的偏差可以用来调整对持续吸毒和危险行为的估计。目标3和4将通过在纽约招募的300名受试者的队列研究实现。注射吸毒者中的吸毒和艾滋病毒风险行为往往被视为地方现象，吸毒行为、风险行为和艾滋病毒流行病发生在特定的地理区域内。拟议的研究将提供数据和研究技术，以形成一个互补的视角，即看到吸毒做法和血液传播的病原体在一个松散整合的全国非法吸毒“系统”内扩散。